Walther A, Schellhaass A, Böttiger B W, Konstantinides S
Klinik für Anaesthesiologie, Universitätsklinikum Heidelberg, Heidelberg.
Anaesthesist. 2009 Oct;58(10):1048-54. doi: 10.1007/s00101-009-1616-y.
Acute venous thromboembolism is a common cardiovascular emergency. Acute pulmonary embolism (PE) is present in one third of these patients. With an average lethality rate of 11% within the first two weeks following diagnosis, approximately 40,000 patients in Germany die annually as a result of PE; therefore, their diagnosis and therapy is of particular importance. For this reason, the European Society of Cardiology published guidelines on diagnosis and therapy in 2000. The current article presents and discusses the points as updated and extended in the 2008 version of the guidelines, including: (1) initial risk stratification--when PE is already suspected; (2) diagnostic procedures and algorithms; (3) further risk stratification; (4) therapeutic strategies in the acute phase; (5) further management and (6) long-term anticoagulation and secondary prophylaxis.
急性静脉血栓栓塞是一种常见的心血管急症。其中三分之一的患者存在急性肺栓塞（PE）。在诊断后的头两周内，平均致死率为11%，德国每年约有40000名患者死于PE；因此，其诊断和治疗尤为重要。出于这个原因，欧洲心脏病学会于2000年发布了诊断和治疗指南。本文介绍并讨论了2008年版指南更新和扩展的要点，包括：（1）初始风险分层——当已经怀疑有PE时；（2）诊断程序和算法；（3）进一步风险分层；（4）急性期治疗策略；（5）进一步管理；以及（6）长期抗凝和二级预防。
